Patients were referred to the contraceptive and sexual health service with non-palpable Implanon. Following a clinical assessment and examination of the arm where the implant had been inserted, an ultrasound examination was carried out to identify and locate the implant. These implants were subsequently removed, some under general anesthesia and others under local anesthesia.

Twenty-seven patients were referred to the unit with impalpable Implanon rods. In four cases, the rods were palpable and removed in the clinic setting without further intervention. Identification of the implants was achieved in 21 of the remaining 23 instances using ultrasound. All 21 Implanon rods identified by ultrasound were successfully removed. In just over 52% of women, a previous attempt at removal had been undertaken before referral.

It is possible to identify and locate impalpable Implanon rods with ultrasound aid, facilitating their subsequent safe removal. Although previous reports have identified ‘lost’ implants using ultrasound, this is the first case series to discuss measuring the skin/implant depth. Together with the implant’s precise position, it aids removal. All health professionals inserting and removing contraceptive implants should have been appropriately trained.

Reference: https://srh.bmj.com/content/32/3/153

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